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Nowacki M, Wiśniewski M, Werengowska-Ciećwierz K, Terzyk AP, Kloskowski T, Marszałek A, Bodnar M, Pokrywczyńska M, Nazarewski Ł, Pietkun K, Jundziłł A, Drewa T. New application of carbon nanotubes in haemostatic dressing filled with anticancer substance. Biomed Pharmacother 2014; 69:349-54. [PMID: 25661381 DOI: 10.1016/j.biopha.2014.12.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 12/11/2014] [Indexed: 12/13/2022] Open
Abstract
The drug-carrier system used as innovative haemostatic dressing with oncostatic action is studied. It is obtained from CDDP (cisplatin) doped SWCNT (single walled carbon nanotubes), modified and purified by H2O2 in hydrothermal treatment process. In the in vivo nephron sparing surgery (NSS) study we used 35 BALB/c nude mice with induced renal cancer using adenocarcinoma 786-o cells. Animals were divided into four groups: CDDP(M-), CDDP(M+), CONTROL(M-) and CONTROL(M+). In CDDP(M-) and CDDP(M+) groups we used, intraoperatively, carbon nanotubes filled with cisplatin (CDDP). In CONTROL(M-) and CONTROL(M+) groups carbon nanotubes were used alone. During NSS free margin (M-) or positive margin (M+) was performed. In the CDDP(M-) group, we do not observe local tumor recurrences. In Group CDDP(M+) only one animal was diagnosed with tumor recurrence. In control groups the recurrent tumor formation was observed. In our study, it is shown that CDDP filled SWCNT inhibit cancer recurrence in animal model NSS study, and can be successfully applied as haemostatic dressings for local chemoprevention.
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Affiliation(s)
- M Nowacki
- N. Copernicus University, Chair of Regenerative Medicine, Tissue Engineering Department, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Karłowicza St. 24, 85-092 Bydgoszcz, Poland
| | - M Wiśniewski
- N. Copernicus University, Department of Chemistry, Physicochemistry of Carbon Materials Research Group, Gagarin St. 7, 87-100 Toruń, Poland
| | - K Werengowska-Ciećwierz
- N. Copernicus University, Department of Chemistry, Physicochemistry of Carbon Materials Research Group, Gagarin St. 7, 87-100 Toruń, Poland
| | - A P Terzyk
- N. Copernicus University, Department of Chemistry, Physicochemistry of Carbon Materials Research Group, Gagarin St. 7, 87-100 Toruń, Poland.
| | - T Kloskowski
- N. Copernicus University, Department of Clinical Pathomorphology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Jagiellońska 13-15, 85-067 Bydgoszcz, Poland
| | - A Marszałek
- Medical University of Warsaw, Department of General, Transplant and Liver Surgery, Banacha 1a, 02-097 Warsaw, Poland
| | - M Bodnar
- Medical University of Warsaw, Department of General, Transplant and Liver Surgery, Banacha 1a, 02-097 Warsaw, Poland
| | - M Pokrywczyńska
- N. Copernicus University, Chair of Regenerative Medicine, Tissue Engineering Department, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Karłowicza St. 24, 85-092 Bydgoszcz, Poland
| | - Ł Nazarewski
- N. Copernicus Hospital, Urology and Oncological Urology Department, Batorego St. 17/19, 87-100 Toruń, Poland
| | - K Pietkun
- N. Copernicus University, Chair of Regenerative Medicine, Tissue Engineering Department, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Karłowicza St. 24, 85-092 Bydgoszcz, Poland
| | - A Jundziłł
- N. Copernicus University, Chair of Regenerative Medicine, Tissue Engineering Department, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Karłowicza St. 24, 85-092 Bydgoszcz, Poland
| | - T Drewa
- N. Copernicus University, Chair of Regenerative Medicine, Tissue Engineering Department, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Karłowicza St. 24, 85-092 Bydgoszcz, Poland; N. Copernicus Hospital, Urology and Oncological Urology Department, Batorego St. 17/19, 87-100 Toruń, Poland
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Schenck M, Eder R, Rübben H, Niedworok C, Tschirdewahn S. [Organ and kidney function preservation in renal cell carcinoma]. Urologe A 2014; 53:1329-43. [PMID: 25142788 DOI: 10.1007/s00120-014-3558-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The organ-preserving partial nephrectomy has increasingly established itself in small unilateral renal tumours (<4 cm) with contralateral healthy kidney and counter gained in recent years in importance. There was found a significantly increased cardiovascular mortality rate and deteriorated quality of life, the more intact kidney tissue has been removed. OBJECTIVES In the present study, the influence of pre- and perioperative factors on direct postoperative course was examined, including 5-year survival rate and relapse behaviour after open organ-preserving partial nephrectomy in our own collective. MATERIALS AND METHODS In this retrospective study of 1657 patients were collected, who underwent surgery between 2007 and 2013 in the Department of Urology at the University Hospital Essen because of a renal tumour. 38 % of these operations (n = 636) were performed organ-preserving. In this trial there are factors identified that have an impact on need of blood transfusion and length of hospitalization in organ-preserving operation method. RESULTS No independent parameter can be determined for the need of blood transfusion. Tumour size and thus time of resection procedure does not affect the need of erythrocytes administration. In addition, the tumour size influences neither the postoperative serum-haemoglobin nor serum-creatinine. Increased patient age and female gender are identified as non-modifiable factors, which cause a longer hospitalisation. Postoperative pain therapy can be considered as a variable size, which does not affect the length of hospital stay. Modifiable factors that increase the overall length of stay, however, are the type of direct postoperative monitoring (ICU vs. anaesthetic recovery room) and the administration of blood transfusions. CONCLUSIONS There are constant factors, which can be associated with a longer residence time in the framework of an organ-preserving partial nephrectomy. Further there is shown evidence of the independence of the tumour size - in addition to proven good oncological results - of an extension of indication of organ-preserving nephrectomy of tumours > 4 cm.
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Affiliation(s)
- M Schenck
- Urologische Universitätsklinik Essen, Hufelandstraße 55, 45122, Essen, Deutschland,
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Qi J, Yu Y, Huang T, Bai Q, Kang J, Liang J, Wu Y. Predictors of postoperative renal functional damage after nephron-sparing surgery. World J Surg Oncol 2013; 11:216. [PMID: 23987305 PMCID: PMC3765796 DOI: 10.1186/1477-7819-11-216] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 08/05/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although nephron-sparing surgery has been reported not to affect total renal function, it is a non-negligible fact that functional damage of the operated kidney usually results, for various reasons. This study aimed to explore the effects of preoperative baseline characteristics, tumor characteristics, and function protection methods on postoperative renal damage. METHODS This study was a retrospective review of 51 patients who underwent open nephron-sparing surgery. The mean age of the patients (39 men, 12 women) was 54.2 ± 13.9 years, range 32 to 71 years. The glomerular filtration rate (GFR) was measured preoperatively and 6th months after the operation. Univariate analysis was used to screen indicators with significant differences in different levels of renal function damage. All variables found to be significant on univariate analysis were entered into a multiple logistic regression model to predict risk factors for renal function damage. RESULTS Univariate analysis showed that there was a significant difference in age, GFR of operated kidney, tumor diameter, tumor depth, and ischemic protection type between patients with little damage and those with heavy damage (P < 0.05). Forward stepwise logistic regression analysis suggested that age (odds ratio, 3.08; 95% confidence interval 1.78 to 7.04; P = 0.037), preoperative GFR of operated kidney (odds ratio, 0.51; 95% confidence interval 0.11 to 0.73; P = 0.033), and tumor diameter (odds ratio, 5.49; 95% confidence interval 2.14 to 7.88; P = 0.012) and depth (odds ratio, 5.82; 95% confidence interval 2.66 to 8.06; P = 0.010) were independent risk factors for postoperative renal function damage. CONCLUSIONS Patients with older age, poor renal function, and large tumor diameter and depth might be at higher risk of renal function damage after nephron-sparing surgery.
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Affiliation(s)
- Jun Qi
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai JiaoTong University, No,1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China.
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Könyves K, Engert Z, Molnár I, Pánykó E, Varga L, Farkas J, Márkus E, Hajós G, Scheid S, Rajnai I. [Our experience with nephron-sparing surgery in the past nine years]. Orv Hetil 2009; 150:1563-7. [PMID: 19643722 DOI: 10.1556/oh.2009.28695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
UNLABELLED Surgical therapy is the only curative therapeutic approach for the treatment of renal cell carcinoma. Nephron-sparing surgery for renal cell carcinoma, when performed by proper indication, provides recurrence-free and long-term survival rates similar to those observed after a radical surgical procedure. AIM In this retrospective study we present our experiences on open nephron-sparing surgery. We describe the rates of different indications of nephron-sparing surgery, the rates of different hystopathological findings, the complications and the long-term cancer specific survival rates. METHODS We reviewed retrospectively the data of 33 patients who had nephron-sparing surgery with T1 tumors between 1999 and 2008 in our department. The last patients' status evaluation was carried out in March 2009. The mean follow up was 4.64 years. RESULTS 82% of the patients had an elective indication, 3% had relative and 15% had absolute indication for nephron-sparing surgery procedure. The mean tumor greatest dimension was 2.86cm. The hystopathologic review revealed 94% clear cell, 6% papillary renal cell carcinomas in the class of malignant renal tumors. The 1- and 5-year cancer-specific survival chance were 93.8%. We had to do nephrectomy because of postoperative bleeding and urinoma in 3 cases. CONCLUSION Nephron-sparing surgery is an acceptable and safe treatment that provides excellent long-term cancer specific survival rates for T1a renal cell carcinoma patients.
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Affiliation(s)
- Károly Könyves
- Vas Megyei Markusovszky Kórház Nonprofit Zrt., Urológiai Sebészeti Osztály, Szombathely.
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Becker F, Siemer S, Kamradt J, Zwergel U, Stöckle M. Important aspects of organ-preserving surgery for renal tumors: indications, new standards, and oncological outcomes. DEUTSCHES ARZTEBLATT INTERNATIONAL 2009; 106:117-22. [PMID: 19568369 DOI: 10.3238/arztebl.2009.0117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2008] [Accepted: 09/24/2008] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Organ-preserving surgery for renal tumors has become more common over the past two decades. At first, part of the kidney, rather than all of it, was resected only if there was an absolute indication for doing so, i.e., if the tumor was located in an anatomically or functionally solitary kidney or if renal failure was already present. Now that favorable oncological outcomes have been demonstrated, renal tumors are increasingly often removed with only partial resection of renal tissue even when the indications are less stringent, including when the other kidney is healthy. METHODS The indications for, and oncological outcomes of, partial renal resection are presented and discussed on the basis of a selective literature search of Medline as well as the guidelines of the European Association of Urologists (EAU). RESULTS AND CONCLUSIONS The EAU, in its new guidelines for renal cell carcinoma, recommends partial renal resection as the standard treatment for tumors less than 4 cm in size that are wholly contained within one kidney when the other kidney is healthy. This practice yields comparable outcomes to those of nephrectomy, with tumor-specific five-year survival rates exceeding 90%. In major urological centers, partial resection is favored even for tumors larger than 4 cm, as long as they are in a favorable location. Nonetheless, the estimated rate of nephrectomy for tumors less than 4 cm in size currently remains very high in Germany, as it does in American studies, even though the organ-preserving resection of such small tumors usually results in cure.
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Affiliation(s)
- Frank Becker
- Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
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